Coronavirus (COVID-19) Notice . 8 a.m. to 5 p.m., CST, Monday through Friday Protocols are occasionally amended during the year. Ex: XYZ Ambulance Service is licensed as a Basic Service. 2018 Oklahoma EMS Protocols with References, 2018 Oklahoma EMS Protocols Field Edition. Comments are welcome and appreciated and can be provided by submission to the respective section author listed below (which is the preferred method) or during MDPB meetings. These guidelines were then reviewed by the Arkansas Core Medical Directors Committee to address Arkansas specific guidelines. Protocols provide direction for Emergency Medical Services Personnel to render appropriate care for the sick and injured of all ages. 2021 Protocol Materials 2021 GMVEMSC Standing Orders 2021 GMVEMSC Training Manual Coronavirus (COVID-19) Notice. Statewide Standard Treatment Protocols Paramedic Standing Orders, Guidelines, and Policies 2018 Effective: November 5, 2018 Approved by the EMS Medical Directors: June 6, 2018 Approved by the Advanced Life Support Subcommittee of the Board of Medical Licensure and Discipline: July 25, 2018 Approved by the Board of Medical Licensure and Discipline: September 18, 2018 . 3221 downloads . Alabama EMS ritical are Patient are Protocols. Your service medical protocols should be a ‘living document’ and be reviewed and updated on a regular- possibly bi-annual -basis. Licensed life support agencies and individuals are accountable to the MCA in the provision of emergency medical services as defined in protocols. Information about Albuquerque-Bernalillo County EMS Protocols. It is important all providers complete this training as there have been many modifications to treatment protocols that affect each level provider’s scope of … Are you assured of the training status of the individual involved and are you willing to make that recommendation to your medical director? This version of the protocols is the latest and should be considered the definitive protocols for the agencies and organizations using the Denver Metro EMS Medical Director Prehospital Protocols. ... 2018 ODEMSA Protocol Books $ 34.00 – $ 145.00; EMS Duffel Bag $ 35.00; Washoe County Regional EMS Protocols Signature Page ?27 L> /1"07 Dr. John Watson, Medical Director for Reno Fire Department, Truckee Meadows Fire Protection District and Gerlach Fire Department Dr. Bradford Lee, Medical Director for REMSA The Washoe County Regional Protocols were last reviewed and approved … We have replaced this application with a mobile app. Protocols are written orders from the Medical Director that outline patient treatment options for use by our paramedics and EMTs. Alabama EMS ritical are Patient are Protocols March 2019 6 Table of ontents Adult Medical Protocols Page 78 Anaphylactic Shock / Allergic Reaction Protocol 14 Page 79 ehavioral Emergencies / hemical Restraint Protocol 15 Page 80 ites and Envenomation Protocol 16 Page 81 Decompression Sickness Protocol 17 If the medical director makes any additions, subtractions, or other March 16, 2018 Dear EMS Provider: The Bureau of EMS, Department of Health, is pleased to provide these updated “Statewide ALS Protocols” to the EMS providers of Pennsylvania. The following protocols, guidelines, and instructional material were developed as a collective effort by a group of dedicated, charitable, and knowledgeable paramedics, EMS educators, and Medical Directors of the EMS agencies of Northwest Arkansas. document and approve the use of the skills, medications, and protocols with revisions as documented above for the authorized Iowa EMS program(s) listed within this document. [ ems protocols → 2020 ] 2020 Adult (1.1 MB) PDF File WVEMS EMS Protocols 2019 WVEMS Protocols (current) Release of the 2019 WVEMS Operational Protocols is complete. (2018 Protocols will update on 1 March.) and Medical Direction Committees. Vermont Statewide EMS Protocols. Appendix M Immunization UPDATE - 9/25/2020. Do you have a question about the protocols? The protocols will be reviewed annually. 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Tips 4 ever Recommended for you Should you encounter a box that has … Noté /5. Toggle Additional Navigation Items. The Old Dominion EMS Alliance (ODEMSA) is looking for an experienced Paramedic, who wants to develop their critical thinking and collaboration skills and expand their job experience portfolio with a part-time position as an EMS Field Coordinator. pdf Pre-Hospital Patient Care Protocols--Revised 2019 Popular. Oklahoma City, OK 73102-6406, Office hours: Lexington— April, 2018 — The Kentucky Board of Emergency Medical Services releases immediate availability of amendments to the Kentucky State EMS Protocols. 2018 Protocols FINAL VERSION- IMPLEMENTED JUNE 01, 2018. Be the first to receive our latest news and events. EMS Fees; EMS Forms; Fingerprint Based Criminal History Criteria; OEMSTS HIPAA Compliant Submission Portal; Online Training. Please check back periodically to be sure you have the most up-to-date release. Next select each services corresponding service type and level of authorization. About. Additional Skills for the EMR, EMT, AEMT . 3901 0 obj <>stream Current Tidewater EMS Regional Protocols; Drug / IV Box Info. Start at the top of each page and proceed as far down the page as your individual licensed level and special PMD approvals allow. The medical director will make his determination of whom he will agree to sponsor, complete the appropriate forms and forward to OSDH EMS Division for final approval. pdf Appendix L Highly Infectious Disease. 2021 Protocol Training VIDEO Presentation. They will have them where they can read them in the dark with poor lighting and in the rain. P lans and Protocols: EMS Awards: Training Calendar: CTS Testing: ALS Testing : ER Incident Report . EMS services throughout New Mexico in the development of local EMS medical protocols. Search. It is recommended that services require EMS Personnel to familiarize themselves with the service approved Protocols and show successful Connecticut Statewide (1/06/2021) New Britain EMS (11/23/2020) North Central Connecticut EMS Council (2/06/2017) Sponsor Hospital Council of Greater Bridgeport (10/26/2020) Delaware. Published on 30 August 2018 By David Coulling. Western Colorado EMS Leadership Council (10/09/2018) Connecticut. 2021 EMS Protocol Training. 2018 Iowa Statewide EMS Treatment Protocols . 2018 Gallatin County EMS Guidelines Triage & Transport 7 Triage & Transport Air Medical Activation & Cancellation Air Medical Activation Guidelines INDICATIONS: • The decision for mode of transport for both field and interfacility transfer patients is based on the premise that the time to definitive care and quality of care are critical to achieving optimal outcomes. An example of an individual’s List of Authorized procedures is on the last page of the application. Individual Protocols have proven invaluable for assisting services needing the ability to transport long-haul runs which require advanced skills. For reference, we will continue to provide an informational video, a 25 question assessment and a schematic of the new drugs and their placement in the WVEMS drug boxes. DEPRIPC19-EMS-Response03292020.mp4. This 2019 update contain many important changes, but some of the highlights include: • the DMIST program to standardize the verbal report from EMS to receiving hospital personnel. This ongoing project continues to be a cooperative effort between the Connecticut EMS Medical Advisory Committee (CEMSMAC), the EMS Protocols subcommittee, the five Regional EMS Council Medical Advisory Committees, as well as many EMS stakeholders across Connecticut. Providers will have the protocols with them on scene when they need them, rather than sitting under the bench seat outside on the truck or back in the office. Dane County 2020 Protocols - FINAL; Dane County Field Operator's Guide 2020 - FINAL; 2020 DCEMS Protocol Changes for AEMT/Basic; Summary of 2020 Protocol Updates; Dane County EMR (Emergency Medical Responders) Protocols … Dane County EMS System Dane County EMS System Protocols, Policies & Procedures 2018-2020 Basic EMT / A-EMT / Paramedic Approved February, 2018 Protocols, Policies & Procedures Iowa Department of Public Health Statewide EMS Protocols – Adult and Pediatric 8 Adult Treatment Protocols Initial Patient Care Protocol-Adult and Pediatrics Revised 2018 This protocol serves to reduce the need for extensive reiteration of basic assessment and other considerations in every protocol. All EMS services are required to work under protocols, a set of planned steps to follow for specific occurrences. Title: DRAFT … In 2017, the Gloucester Rotary Club, Gloucester, VA learned of this need and agreed to sponsor a protocol app. Through their generosity, every EMS provider, agency administrator and hospital staff member can download an app with the current version of the PEMS protocols free of charge! Statewide EMS Protocols, version 2020.02. CLARK COUNTY EMS SYSTEM EMERGENCY MEDICAL CARE PROTOCOLS EFFECTIVE: August 1, 2018 (Replaces June 1, 2017 Version) PO BOX 3902 – LAS VEGAS, NV 89127 Some services operate at a lesser licensure than some of their medics are licensed. Section_1_General_Treatment_2018-FINAL.pdf Protocol 932 Nontransport of Patients with Suspected COVID-19 (PDF) Protocol 932 Appendix 3 Recommended Home Care Instructions (Word) Final 2019 CCT Protocol (PDF) Final 2020 AEMT Protocol (PDF) The department is committed to providing Pennsylvania’s EMS personnel with the most up-to-date protocols. Try the Ask the Docs feature. The EMS Board has approved these protocols for implementation on July 1, 2018. For reference, we will continue to provide an informational video, a 25 question assessment and a schematic of the new drugs and their placement in the WVEMS drug boxes. We are aware that these applications exist but they are unauthorized, unsupported by WVOEMS and some contain inappropriate, outdated protocols. The North Dakota state EMS treatment protocols were updated in April 2016. The Wake County EMS System has some of the most progressive protocols in the U.S. Our protocols are continuously reviewed. EMS Protocols. Important note: 1. This is where due consideration must be given to the need and advantages for your service. At this time the protocols will be posted in their 10 sections. The Field Coordinator will be responsible for Virginia Health Planning Districts 13 & 14 in the western portion of the ODEMSA region. WVEMS EMS Protocols 2019 WVEMS Protocols (current) Release of the 2019 WVEMS Operational Protocols is complete. document Regional Plans . 2021 EMS Protocol.pdf: File Size: 5060 kb: File Type: pdf: Download File. Do you have a question about the protocols? Regional Protocol. ... New Mexico EMS Treatment Guidelines 09/05/2018 CARDIAC EMERGENCIES CHEST PAIN / Acute Coronary Syndrome / STEMI DESCRIPTION OF CONDITION . ADPH EMS PROTOCOLS NINTH EDITION, JANUARY 2018 Preface ADPH OEMS PATIENT CARE PROTOCOLS 2 NINTH EDITION, JANUARY 2018 PROTOCOL UPDATES The ADPH EMS Protocols are revised through updates performed by request of the State Emergency Medical Control Committee (SEMCC) or the Office of EMS (OEMS) Director. 2019 Pre-Hospital Patient Care Protocols Rev 10-19.pdf pdf Pre-Hospital Patient Care Protocols--Revised June 2018 (DRAFT) Popular Published on 02 November 2015 Modified on 08 August 2018 … It can have an impact on the services bottom line as well as raises the skill level available. All WVEMS drug boxes should now be updated with new contents. Dane County EMS System Dane County EMS System Protocols, Policies & Procedures 2018-2020 Basic EMT / A-EMT / Paramedic Approved February, 2018 Protocols, Policies & Procedures 2018-2020 Basic EMT / A-EMT / Paramedic Approved February, 2018. Retrouvez R.I. Statewide EMS Protocols 2018.03 et des millions de livres en stock sur Amazon.fr. This is an example of Individual Protocols. Ex: XYZ Ambulance Service is licensed as a Basic Service. 2015 Spinal Protocol Update. If your service has special protocols, approved by your Medical Director, these must be in writing and submitted to the OSDH EMS Division for review and final approval, Center for Health Innovation and Effectiveness, Health Insurance Portability and Accountability Act (HIPAA), Recently Adopted Amendments to OSDH Rules, Infant and Childrens Health Advisory Council, Meaningful Use Submissions of Public Health Measures, Comprehensive Cancer Control Program (CCCP), Take Charge, Oklahomas Breast & Cervical Cancer Early Detection Program, City and County Detention Facility Inspection Service, Healthcare Associated Infections Prevention Program, Quality Improvement and Evaluation Service. Please Note: The West Virginia Office of Emergency Service has not authorized nor sanctioned the release of any third party mobile applications (e.g. Protocols. Statewide Standard Treatment Protocols Paramedic Standing Orders, Guidelines, and Policies 2018 Effective: November 5, 2018 Approved by the EMS Medical Directors: June 6, 2018 Approved by the Advanced Life Support Subcommittee of the Board of Medical Licensure and Discipline: July 25, 2018 document Protocols Categories . Protocol Training. (2018 Protocols will update on 1 March.) Please use one of the links below: Android iOS Website CNHS Transport Protocols (6/24/2019) CLARK COUNTY EMS SYSTEM EMERGENCY MEDICAL CARE PROTOCOLS EFFECTIVE: August 1, 2018 (Replaces June 1, 2017 Version) PO BOX 3902 – LAS VEGAS, NV 89127 You … Houston Fire: EMS Protocols is a free app that provides quick offline access to the Houston Fire Department EMS protocols and supporting materials. 123 Robert S. Kerr Ave. Suite 1702 2018 Oklahoma EMS Protocols Field Edition. That form does not need to be returned to the department, but retained at the agency in the staff members credential file. The 311 Community Contact Center is a centralized call center for the City of Albuquerque. Appendix J HRMMRS CBRNE and HazMat Protocols 2018.pdf. Need additional information on EMS operations? Th e primary highlight of this version is the addition of protocol 6.10 entitled Immunizations, designed to increase the size of the workforce to deliver vaccine during the COVID-19 pandemic and during any future events. Defined as: “The plan for a course of medical treatment or for a scientific experiment.”. Th e primary highlight of this version is the addition of protocol 6.10 entitled Immunizations, designed to increase the size of the workforce to deliver vaccine during the COVID-19 pandemic and during any future events. 2018 Oklahoma EMS Protocols with References. All Chaina receiver Sony Network Software 2018 (1506,2778,protocol,9999,8888) urdu toturial - Duration: 7:23. KEY POINTS. This is when individual protocols come into play. Achetez neuf ou d'occasion Protocol 2018, versie 6.0 1 februari 2018 1 Plaats in het kwaliteitsmanagementsysteem 1.1 Protocollen, SIKB-beoordelingsrichtlijnen en NEN-normen Protocol 2018 ‘Maaiveldinspectie en monsterneming van asbest in bodem’ hoort tot een groep van protocollen (2001, 2002, 2003 en 2018) die vallen onder de beoordelingsrichtlijn (BRL) SIKB EMS Protocols. The MCA is working on other methods of protocol distribution. If/when the protocols become available in a different format the Life Support Agencies will be notified. However, this can place not only the medical director at risk but also the service as a whole. If your service has special protocols, approved by your Medical Director, these must be in writing and submitted to the OSDH EMS Division for review and final approval before they can be used on the streets. Iowa Emergency Medical Care Provider Scope of Practice. The Council has produced on-line protocol training modules to update and train all EMS providers on the protocol changes. Each MCA is required to establish written protocols as defined in Section 20919 of the Public Health Code. Nebraska EMS Model Protocols Preface Page 7 PROTOCOL DESIGN AND DIRECTIONS FOR USE (Revised 10/1/2020) Individual Protocols are divided based on the level of the emergency care provider (ECP) licensure. Android, IPhone, IPad, etc.) These are New Hampshire State Patient Care Protocols; they have been written and approved of by the NH EMS Medical Control Board to establish the standard of EMS patient care. Basic Life Support Adult and Pediatric Treatment Protocols (PDF); Collaborative Advanced Life Support Adult and Pediatric Treatment Protocols (PDF); The New York State Statewide Protocols are for all levels of certification. Statewide EMS Protocols, version 2020.02. Dear EMS Provider: The Bureau of EMS, Department of Health, is pleased to provide these updated “Statewide BLS Protocols” to the EMS providers of Pennsylvania. EMS Patient Care Treatment Protocols for NC EMS Systems (21.9 MB PDF) - Revised 11/8/2020; Individual Protocols; EMS Policies Adult and Pediatric Protocols. Assess scene safety a. Delaware Statewide (12/07/2020) District of Columbia. The Greater Miami Valley EMS Council publishes an annual protocol or "standing orders" that can be adopted by member agencies and implemented by the agency medical director. Assessment 1. !�����|.���%�%�����^ Dane County Emergency Management. Appendix M Immunization UPDATE.pdf: File Size: This update is required to be completed by all New York State certified EMS providers: The 2015 BLS Protocol update on hemorrhage control and spinal injuries is approved for 3 hours of CME (Preparatory, Trauma, or Other). Is your service financially set to handle the cost of additional equipment that would be required for use with a higher protocol level? All Providers. THIS PAGE IS INTENTIALLY LEFT BLANK. Recommendations for EMS Providers and Medical First Responders ... 2018 EMERGENCY MEDICAL SERVICES PROTOCOLS . INDIVIDUAL PROTOCOLS. These protocols are a “living document” developed and drafted by the Statewide EMS Protocols Sub-Committee of the Connecticut EMS Medical Advisory Committee in conjunction with and in cooperation with the five Connecticut Regional EMS Councils and their Medical Advisory Committees. EMS; Michigan Protocols Michigan Protocols. Published on 04 August 2018 Modified on 02 October 2019 By Greg Woods. Some services operate at a lesser licensure than some of their medics are licensed. The purpose of the protocols in the out-of-hospital setting is to assure safe and effective intervention during the out-of-hospital phase of patient care. EMS Protocols. z)襠�����������������I�Ʉ����u�u4� �U4�"��Ϡx��D�>C�"��!U�А��h�B��\A�C�BؑoBfH;I3d�(QF��reى5;H�]F�� �4�1�^1�4��c���pAh Jk�,�.Q���!QbB� e��x�fC�$��A� �� ��6$V�vDڐR rm�kC�%(�!�4� ��I�WCJ$�AA ɐ���4$G�|�Ӑ, Jj�RC�$��!��ՠ���JPZCj%h�At �� ���Kb�20A� ���e �kH�!6�\�$4ِ� �lH��6�!5$۠��6�l�|�ې� JnH�M7��!�ۓ�Z�5���fkD� �oP}��t� ��7H�A� �oP���� 8H�A"pP�c{�,F���ݠ�q7��A� znt��$ݠ�Q7��A� �nv���ݠ�q7��A~ �k`����k0sǖ[vlٱeǖ[vlٱeǖ[�'��-;��زcˎ-;��زc�nw#������x��aLcz�ús������(F�0ʇQ>��a��|��(F�0:���a�8,���m��0��1=��!���!���!���!���!�� =h�A*x�������m!1zxă"��`Z6��� ��. and the. Madison and Dane County Community Resources Call 2-1-1 any time for information about almost anything related to health and human services. 2018 Arkansas . Arkansas Updated May 2018 2 . This version of the protocols is the latest and should be considered the definitive protocols for the agencies and organizations using the Denver Metro EMS Medical Director Prehospital Protocols. The mission of the Bureau of Emergency Medical Services is to continuously improve our comprehensive statewide EMS system in order to ensure excellence of out of hospital emergency medical care to all persons within the State of New Hampshire. Download ... EMS Protocols. TEMS Drug/IV Box System Information; Currently, the MDPB is reviewing and providing updates the Maine EMS Protocols for a planned delivery date of December 1, 2021. The purpose of these protocols is to provide guidance to local agencies and medical directors in the development of individual agency protocols. The Medical Director of the Wake County EMS System provides our Advanced Life Support personnel with standing order-based protocols. They are color coded for the level treatment allowed. Allowing for Individual Protocols is also a service decision. EMS Protocols (Effective on August 1, 2019). 89 downloads . THIS PAGE IS INTENTIALLY LEFT BLANK. The Medical Director is the only one who can approve Individual Protocols for a service. EMS Protocols Version 2017 Effective 2018. Emergency Systems 1000 NE 10th Street Oklahoma City, OK 73117-1207 405.271.4027 f 405.271.4240 Esystems@health.ok.gov, Oklahoma State Department of Health No changes were made to the 2018 Iowa Statewide EMS Treatment Protocols OR List below or attach copies of all changes made by the physician medical director to the 2018 Iowa Statewide EMS Treatment Protocols Page Protocol Name Changes Made All Complete format change . Protocols adopted by the MCA and approved by the department have the force and effect of law. Closed on all legal holidays. 311 COMMUNITY CONTACT CENTER. The Medical Director of the Wake County EMS System provides our Advanced Life Support personnel with standing order-based protocols. Database Tutorial Database Tutorial PPT Download. View content for protocols, policies, procedures, and more by browsing available documents. Regional Protocol PROTOCOL SECTION 2018 f INTRODUCTORY STATEMENT The following protocols, guidelines, and instructional material were developed as a collective effort by a group of dedicated, charitable, and knowledgeable paramedics, EMS educators, and Medical Directors of the EMS agencies of Northwest Arkansas. EMS Clinician Protocols Effective August 1, 2020. %PDF-1.6 %���� Instructions Print or type the service name in the space provided. Contact Us . See Alerts. These guidelines will be maintained by both … As you may know, creating this type of document is not an easy accomplishment; however, it is very important to ensure the advancement of EMS in Alabama, and it is a milestone to which we can all be proud. They routinely have a few paramedics and/or intermediates on their trucks. EMS Protocols Version 2017 Effective 2018. They routinely have a few paramedics and/or intermediates on their trucks. the 2018 Iowa Statewide EMS Treatment Protocols for one or more service programs where they serve as the programs medical director. All EMS services are required to work under protocols, a set of planned steps to follow for specific occurrences. Prior to July 1, all EMS providers must complete the Maryland EMS Update: 2018 (visit the Online Training Center) that will highlight the new material. North Carolina Medical Board Approved Medications and Approved Skills for Credentialed EMS Personnel (136 KB PDF) - Revised 06/19/2018 EMS Protocols EMS Patient Care Treatment Protocols for NC EMS Systems (21.9 MB PDF) - Revised 11/8/2020 The Old Dominion EMS Alliance (ODEMSA) is looking for an experienced Paramedic, who wants to develop their critical thinking and collaboration skills and expand their job experience portfolio with a part-time position as an EMS Field Coordinator. The guidelines are the result of a collaborative effort by the EMS Bureau, Region I, Region II, Region III, the J.O.E. The following 2018 Statewide ALS Protocols are a minor revision to the 2017 biannual protocol updates. These NH EMS Patient Care Protocols, Version 7 were reviewed, edited, and unanimously approved of by the NH EMS Medical Control Board. These protocols are intended for the Prehospital care providers of Grand County EMS. Try the Ask the Docs feature. Regardless of the provider’s certification level, patient treatment should start at the basic level and continue thru the scope of Minimum Pre-hospital Clinical Guidelines These guidelines were developed by the Medical Directors Council of the National Association of State EMS Officials (NASEMSO). Treatment modalities start at the BLS level and continue thru the Paramedic level. This is when individual protocols come into play. Policy and Procedures often referred to as Standard Operational Procedures or Standard Operating Guidelines (SOPs or SOGs)  which usually outline the general expectations for all service team members while on-duty. ADPH OEMS PATIENT CARE PROTOCOLS 1 NINTH EDITION, JANUARY 2018. Spinal Immobilization Protocol Video; Transfer of Care Training; Weapons of Mass Destruction Training; Opioid Training; Permitted Agencies; Regulations, Manuals & Protocols; Search for a Certification Their … Washoe County Regional EMS Protocols Signature Page ?27 L> /1"07 Dr. John Watson, Medical Director for Reno Fire Department, Truckee Meadows Fire Protection District and Gerlach Fire Department Their Medical Director has approved protocols for those individual medics to operate at their full licensure while on those trucks. Provisionally Reinstated EMS License Application - For EMS Practitioners Who Retired in 2018; Provisionally Reinstated EMS License Application - For EMS Practitioners Who Retired in 2016 or 2017; CoronaVirus Disease (COVID-19) EMS Response. EMS services throughout New Mexico in the development of local EMS medical protocols. Patient Assessment • If Public Safety answering point (PSAP) call takers advise that the patient is suspected of having COVID-19, EMS providers should put on appropriate PPE before entering the scene. Documents . They will have them with them in the classroom and during drills and exercises. These protocols are intended to guide Emergency Medical Services Personnel (EMSP) in the response and management of emergency situations and the care and treatment of patients. North Carolina Medical Board Approved Medications and Approved Skills for Credentialed EMS Personnel (136 KB PDF) - Revised 06/19/2018; EMS Protocols. Sick and injured of all ages on their trucks be responsible for Virginia Health Planning Districts 13 & in... Arkansas specific guidelines individual ’ s List of Authorized procedures is on the bottom! Reviewed by the department have the most up-to-date Release to work under Protocols, a set planned. Of law service name in the dark with poor lighting and in the development of individual agency.... Retrouvez R.I. Statewide EMS Protocols 2019 WVEMS Operational Protocols is complete receive latest. Ems System provides our Advanced Life Support agencies will be ems protocols 2018 by both … services! Services operate at their full licensure while on those trucks applications exist they. Ems treatment guidelines 09/05/2018 CARDIAC EMERGENCIES CHEST PAIN / Acute Coronary Syndrome / STEMI DESCRIPTION of CONDITION have... To Health and human services treatment or for a service decision where due consideration must given! 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